Americans living in rural areas have been identified by several federal agencies as a priority population affected by health disparities. Disparities have been identified in cancer screening, diagnosis and treatment for rural residents. However, although an estimated 21% or more of all United States cancer survivors reside in rural areas, little is known about the long-term cancer survivorship experience of rural persons with a history of cancer. Due to a variety of reasons such as long travel distances to obtain care and a limited number of primary and specialty healthcare facilities, this population may be at risk for poorer survivorship care and health outcomes. This lack of information about rural cancer survivors hinders public health planning, allocation of medical resources, and the development of interventions to target this potentially vulnerable population. This application seeks to provide population-based information about the characteristics and health status of adult cancer survivors who reside in rural areas of the United States. Specific aims are to: (1) characterize US cancer survivors residing in rural areas and identify how they may differ from non-rural survivors; (2) compare the health status of rural cancer survivors with that of non-rural survivors; and (3) assess whether differences in health between rural and non-rural survivors are accounted for by known risk factors including physical activity, body mass index, smoking history, socioeconomic status, and access to medical care. Health status outcomes will include self-reported health, prevalence of comorbid medical conditions, psychological distress, and health-related unemployment. Analyses will be conducted using data from the National Health Interview Survey (NHIS), an annual in person survey of 30-40,000 households that provides a representative sample of the US civilian, non-institutionalized population. The proposed research will generate the first population-based estimate of the number and proportion of cancer survivors who reside in rural areas in the US. Increased knowledge about rural cancer survivors addresses an NCI Strategic Objective, to overcome cancer health disparities, and will inform public health initiatives and guide future grant applications to develop interventions addressing health disparities in rural cancer survivors. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE Despite the estimate that at least 21% of all cancer survivors reside in rural communities, the lack of knowledge about their health status impedes public health planning, allocation of resources, and development of interventions targeting this potentially vulnerable population. The goal of the proposed research is to use National Health Interview Survey data to provide population-based information about the characteristics and health status of adult cancer survivors residing in rural areas of the US.